ISTANBUL, TurkeyFor women with advanced breast cancer, three taxane-based chemotherapy regimens that avoid the potentially cardiotoxic anthracyclines were all equally beneficial as first-line therapy in terms of survival and disease progression. Helena Linardou, MD, PhD, of the Metropolitan Hospital, Athens, presented the results at the 31st Congress of the European Society for Medical Oncology (abstract 143 O).
Dr. Linardou and her colleagues in the Hellenic Cooperative Oncology Group randomized 414 women with advanced breast cancer into three groups. Group A received six cycles of paclitaxel 175 mg/m2 over 3 hours followed by carboplatin to AUC 6 every 3 weeks. Group B received six cycles of gemcitabine (Gemzar) 1,000 mg/m2 over 30 minutes on days 1 and 8 plus docetaxel (Taxotere) 75 mg/m2 on day 8 every 3 weeks. Group C was treated with paclitaxel 90 mg/m2 over 1 hour weekly for 12 weeks. Patients with tumors that overexpressed HER2 were also given trastuzumab (Herceptin). Hormone-sensitive patients received letrozole (Femara) until disease progression, while premenopausal patients had ovarian ablation.
At a median follow-up of about 2 years, no significant differences in response rate, time to progression, survival, or overall toxicity have been seen among the three groups. Dr. Linardou noted that severe myelotoxicity was significantly higher for patients in group B (gemcitabine/docetaxel), and, as expected, severe peripheral neuropathy, although limited, was present only in the paclitaxel arms. She commented that the anthracycline-free option is important, since many breast cancer patients have received adjuvant regimens containing anthracyclines.